Alexander Börve is an orthopaedic surgeon, (spine surgeon) in training at the Sahlgrenska 
IDoc24 is an anonymous advice service using any internet-connected device. Today there is a downloadable iPhone app, MMS service with Swedish SIM cards and an internet web form that enables users to send photos of their skin for a dermatologist’s opinion.
Dr Alexander Borve will be presenting at Doctors 2.0 & You on May 23-24 in Paris, France. We interview him here about iDoc24 and mobile health.
DS: You are an orthopedist by training. How did you get involved in a dermatology idea?
AB: I have always been a fan of technology. At medical school I used the Palm and Handspring handheld devices for my education. When I did my pre-registrar (residency) I spent a lot of time in the ER (A&E- Accident end emergency). For the incoming accidents, the ambulance personnel would take a Polaroid photo of the accident for more information about the accident scene, but this information was not of interest when the patient was in the ER, as every second counts to save the patient. I therefore had the idea that the ambulance personnel would send in a MMS (Multimedia Messaging Service) of the accident scene to a platform where we ER personnel could see what was coming in and prepare ourselves.
This was a great idea, but to get it implemented was another story. I so often met with skepticism from older colleagues and also criticism that I was going to “make money” from a service implemented in a hospital setting. One day my dermatology friend told me of a dinner party she attended. When she presented herself as a dermatologist to the dinner guests, she would have people asking questions about skin problems, which she felt were awkward, especially after some wine. The queries tended to be in places that required removing some clothing…. So I asked my dermatology friend if she could “diagnose” from MMS images and short texts explaining the problem, and it turned out she could. So from there I had the idea that anyone with a skin problem could send in an MMS to dermatologists and receive instant advice.
DS: How do you choose the dermatologists who participate? How many are there?
AB: The dermatologists are mainly my friends. 😉 And through the research I do, I pick the ones that think it is fun and innovative. They do a simple test before I enroll them in the system. We are now 10. There are more that want to join, but we do not have that kind of volume yet. I am now focusing on building an international network: I have Spanish, French, English, and Swedish dermatologists so far.
DS: How many users have you had so far? Do they repeat?
AB: We have had over 6000 downloads of our iPhone app and over 1000 queries asked through our application. On a daily basis we receive an average of three queries. After having been on the news in Sweden during the Euro Melanoma day in May 2011, we received 80 queries per day during that week but it later dropped off. We do have repeats, but it is difficult to measure since the users are anonymous. However, friends of friends tell me they use it whenever they have a visual worry. 99% are satisfied with the service. The users that are not satified think that they will receive a diagnosis. It is important to note that the service is an advice and information service only, a dermatologist’s opinion and it can not replace a dermatologist visit.
DS: How is the patient’s privacy guaranteed?
AB: We do not collect any personal data: no telephone numbers, credit card details, iPhone identification or IP addresses. We only store the image and text on our server with the case number. The user can see the name of the dermatologist, but the doctor cannot see the identification of the sender, so there is no patient doctor relationship.
DS: Is iDoc24 organized as a business? How are the economics coming along?
AB: Yes, we need to make money in order to to further develop it and pay everyone who is involved. The user pays per query. Right now we are making a loss per query, as it only costs €10, but we should be able to break even, if the query costs €20 and we average 120 queries per day. So like all start ups we are looking for funding. A lead investor would be ideal. It might be enough to scale and no VC needed.
DS: What do you think is the right scale for such a service? By country, by continent? Doesn’t climate and skintype play a role in skin lesions? What about differences in medical regulations in various countries?
AB: 80% of people with health queries search Google first. So we have to optimize our web page and advertise through Google. We also have an iFrame web form that can be embedded into any health portal’s internet site. Our platform is intelligent and can answer in several languages so countries and continents are not the problem, but advertising the service, making your product known and trusted is the challenge. Skin types are not a problem. The dermatologists always give advice: 65% receive self care advice and 35% are advised to see a doctor face to face, reducing delays. We comply with Swedish and EU health laws.
DS: You’re speaking at Doctors 2.0 & You in Paris on May 23-24. Why do you recommend attending this conference (besides meeting you there?)
AB: Doctors 2.0 & You is a great event! The event will attract like-minded people from an international setting, which is important for entrepreneurs as we can exchange ideas, get instant feedback and meet potential partners. I am excited to see what other people are doing and what new ideas are around. To create an internet business, you have to think global and not local- I have already established myself in Sweden a country of 9 million people; Europe has 500 million people; partnerships are key in healthcare if you want to go global.
Watch this short video to see how iDoc24 works!
